| Doctor Name: | REGINA KELLY |
| NPI Number: | 1013129675 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0172572308 |
| Business Practice Address: | 66 Main St Plymouth, NH - 032641451 |
| Business Phone Number: | 6035361020 |
| Business Fax Number: | |
| Mailing Address: | Po Box 845, PLYMOUTH |
| State: | NH |
| Postal Code: | 032640845 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 0172572308 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |